PERSONAL REFLECTIONS

I come from a family of health care providers (what we used to call doctors and nurses). My father is a retired thoracic surgeon; his father was a general surgeon in West Virginia. My mother was a surgical nurse, and her mother was a nurse and her father a doctor in Ohio. I also spent time in college working in a hospital. Given that lineage one might imagine that I have a certain comfort level in health care settings. That may have been true at some point in my life, but no longer. And given my education as an environmental psychologist, I am particularly sensitive to the quality of the physical surroundings in which health care occurs.

Two anecdotes will suggest the role of the physical setting in my attitude toward health care. When my daughter was in college, she needed her wisdom teeth extracted. Her dentist recommended an oral surgeon, and we made an appointment for a consultation (consultation first visit; extraction second visit). The office was in a somewhat secluded and run-down commercial area near a number of gas stations and a roller rink. As we approached the office building, we went over railroad tracks and down an incline. At that point my daughter said to me, “This does not inspire confidence.” As it turned out, she felt so negatively about the entire experience that day that we asked her dentist for a second referral and ultimately went elsewhere (see Figure 2.1).